Provider Demographics
NPI:1346495157
Name:PRISCO, MARY RACHEL (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:RACHEL
Last Name:PRISCO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 FOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37210-5307
Mailing Address - Country:US
Mailing Address - Phone:615-228-8902
Mailing Address - Fax:
Practice Address - Street 1:601 W DUE WEST AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-4423
Practice Address - Country:US
Practice Address - Phone:615-227-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-20
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13707363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily